Organization
CRANFORD FAMILY PRACTICE
Active
Parent organization
MEDVANTX, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
570 SOUTH AVE E, BUILDING G-UNIT, CRANFORD, NJ 07016-3200
(908) 272-7970
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
MD417016
NJ
Other
Enumeration date
08/25/2011
Last updated
01/30/2015
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